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Bayern. Naloxon Take-Home Kits: Schulung Betroffener (und Peers) – ein Modellprojekt in Bayern

N.Wodarz, H. Wodarz-von Essen, j.Wollstein, O.Pogarell

Präsentation auf dem 20. Interdisziplinären Kongress für Sucht-Medizin, 04.07. bis 06.07.2019 in München

Wodarz Take Home Naloxon Modellprojekt Bayern2019.pdf

Vital Signs: Pharmacy-Based Naloxone Dispensing - United States, 2012-2018.

Guy GP Jr, Haegerich TM, Evans ME, Losby JL, Young R, Jones CM.

MMWR Morb Mortal Wkly Rep. 2019 Aug 9;68(31):679-686. doi: 10.15585/mmwr.mm6831e1.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687198/

Naloxone as a technology of solidarity: history of opioid overdose prevention

Nancy D. Campbell

CMAJ August 26, 2019 191 (34) E945-E946; doi.org/10.1503/cmaj.190257 

http://www.cmaj.ca/content/191/34/E945

USA. Drug Overdose Prevention & Education (DOPE) Project: San Francisco

Currently, the DOPE Project is the largest single-city naloxone distribution program in the country, responsible for training over 13,000 people in San Francisco(with that number growing every day!). People who use drugs, their loved ones, and surrounding community are responsible for reversing on average 1,500 overdoses a year with DOPE Project naloxone. (2019)

https://harmreduction.org/issues/overdose-prevention/dope-sf

EMCDDA. Take-home naloxone

Introduction: What is naloxone and why is it important?

Drug overdose continues to be the main cause of death among problem drug users. Heroin or other opioids — often consumed alongside other central nervous system depressants such as benzodiazepines and alcohol — are present in the majority of reported fatal overdoses (1). Overdose is common among opioid users: many of them have experienced a non-fatal overdose and most have witnessed one. Death from opioid overdose is caused primarily by respiratory depression leading to cardiac arrest.

Opioid overdose deaths can be prevented through timely administration of naloxone, a potent opioid antagonist drug that rapidly reverses the effects of opioid analgesics by binding to the opioid receptors in the central nervous system (see Spotlight: Naloxone). Because of its effectiveness, naloxone is used by emergency personnel worldwide (2). (EMCDDA, Lissabon, August 2019)

http://www.emcdda.europa.eu/publications/topic-overviews/take-home-naloxone_en

USA. Naloxone: Wide distribution effective in preventing deaths

ANN ARBOR—Broad distribution of the opioid reversal drug naloxone is highly cost-effective in reducing fatal overdoses, according to a new University of Michigan study.

The researchers examined the cost-effectiveness of increased distribution of naloxone to laypeople likely to witness or experience overdose, police and firefighters, and emergency medical services. (University of Michigan, USA, 20.08.2019)

https://news.umich.edu/naloxone-wide-distribution-effective-in-preventing-deaths/

The relationship between pupil diameter and other measures of opioid withdrawal during naloxone precipitated withdrawal.

Bergeria CL, Huhn AS, Tompkins DA, Bigelow GE, Strain EC, Dunn KE.

Drug Alcohol Depend. 2019 Sep 1;202:111-114. doi: 10.1016/j.drugalcdep.2019.05.010.

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/31336328

Public perceptions of naloxone use in the outpatient setting.

Smith JO, Malinowski SS, Ballou JM.

Ment Health Clin. 2019 Jul 1;9(4):275-279. doi: 10.9740/mhc.2019.07.275.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6607948/

Narcan or Nar-can't: Tips and Tricks to Safely Reversing Opioid Toxicity.

Li K, Armenian P, Mason J, Grock A.

Ann Emerg Med. 2018 Jul;72(1):9-11. doi: 10.1016/j.annemergmed.2018.05.010.

Abstract

https://www.annemergmed.com/article/S0196-0644(18)30432-3/fulltext

Vital Signs: Pharmacy-Based Naloxone Dispensing — United States, 2012–2018.

Guy GP Jr., Haegerich TM, Evans ME, Losby JL, Young R, Jones CM. 

MMWR Morb Mortal Wkly Rep 2019;68:679–686. doi.org/10.15585/mmwr.mm6831e1.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6831e1.htm

Take-Home Naloxone for the Emergency Interim Management of Opioid Overdose: The Public Health Application of an Emergency Medicine

Strang, J., McDonald, R., Campbell, G. et al. 

Drugs (2019). doi.org/10.1007/s40265-019-01154-5

https://link.springer.com/article/10.1007/s40265-019-01154-5

Justice involvement patterns, overdose experiences, and naloxone knowledge among men and women in criminal justice diversion addiction treatment.

Gicquelais RE, Mezuk B, Foxman B, Thomas L, Bohnert ASB.

Harm Reduct J. 2019 Jul 16;16(1):46. doi: 10.1186/s12954-019-0317-3.

https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0317-3

Take Home Naloxone: best practice in preventing fatal opioid overdoses for prison leavers

(...) People leaving prison are at the highest risk of overdose and drug-related death in the first weeks following release. This is likely due to reduced tolerance to heroin, increased purity of drugs compared to those used in prison and the tendency of some released prisoners to return to previous drug use patterns.Increasing the uptake of Take Home Naloxone (THN) amongst opioid users leaving prison (and in the community) can help reduce the number of drug-related deaths amongst this high risk population. (The Forward Trust, UK, Pulse#7, Juni 2019)

https://www.forwardtrust.org.uk/media/1891/pulse-7-final.pdf

Pulmonary Complications of Opioid Overdose Treated With Naloxone.

Farkas A, Lynch MJ, Westover R, Giles J, Siripong N, Nalatwad A, Pizon AF, Martin-Gill C.

Ann Emerg Med. 2019 Jun 7. pii: S0196-0644(19)30309-9. doi: 10.1016/j.annemergmed.2019.04.006. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/31182316

Naloxone interventions in opioid overdoses: a systematic review protocol.

Shaw LV, Moe J, Purssell R, Buxton JA, Godwin J, Doyle-Waters MM, Brasher PMA, Hau JP, Curran J, Hohl CM.

Syst Rev. 2019 Jun 11;8(1):138. doi: 10.1186/s13643-019-1048-y.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560883/

Association of Naloxone Coprescription Laws With Naloxone Prescription Dispensing in the United States.

Sohn M, Talbert JC, Huang Z, Lofwall MR, Freeman PR. 

JAMA Netw Open.Published online June 21, 20192(6):e196215. doi:10.1001/jamanetworkopen.2019.6215

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2736179

Naloxone urban legends and the opioid crisis: what is the role of public health?

Crabtree A, Masuda JR.

BMC Public Health. 2019 May 30;19(1):670. doi: 10.1186/s12889-019-7033-5.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543555/

Successful Naloxone Challenge Test in a Patient With Atrial Flutter.

Harlow TR, Peters JR, Anderson DL.

Prim Care Companion CNS Disord. 2019 May 23;21(3). pii: 18l02385. doi: 10.4088/PCC.18l02385.

https://www.psychiatrist.com/PCC/article/Pages/2019/v21n03/18l02385.aspx

Should we worry that take-home naloxone availability may increase opioid use?.

Tas, B., Humphreys, K., McDonald, R., and Strang, J. ( 2019) 

Addiction, doi.org/10.1111/add.14637.

https://onlinelibrary.wiley.com/doi/10.1111/add.14637

USA. Naloxone Has Made Overdosing Less Terrifying

Some drug users say that as long as the lifesaving drug is around, they don’t worry as much about dying. (The Atlantic, USA, 08.06.2019)

https://www.theatlantic.com/health/archive/2019/06/narcan-makes-fentanyl-overdoses-feel-safer-users/591217

Pharmacokinetic Interaction of Naloxone and Naltrexone Following Intranasal Administration to Healthy Subjects.

Krieter PA, Chiang CN, Gyaw S, Skolnick P, Snyder R.

Drug Metab Dispos. 2019 Apr 16. pii: dmd.118.085977. doi: 10.1124/dmd.118.085977. 

http://dmd.aspetjournals.org/content/dmd/early/2019/04/16/dmd.118.085977.full.pdf

Retrospective Review of Need for Delayed Naloxone or Oxygen in Emergency Department Patients Receiving Naloxone for Heroin Reversal.

Heaton JD, Bhandari B, Faryar KA, Huecker MR.

J Emerg Med. 2019 Apr 5. pii: S0736-4679(19)30121-0. doi: 10.1016/j.jemermed.2019.02.015. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30961922

USA. Allowing Pharmacists to Directly Dispense Opioid Antidote Can Sharply Cut Opioid Overdose Deaths

Allowing pharmacists to dispense the opioid antidote naloxone without a physician's prescription can sharply reduce the incidence of fatal opioid-related overdoses, according to a new RAND Corporation study.

States that adopted such laws saw fatal opioid overdoses fall by an average of 27 percent during the second year following passage and 34 percent in subsequent years, according to the study published in the journal JAMA Internal Medicine. (RAND, USA, 06.05.2019)

https://www.rand.org/news/press/2019/05/06.html

Does Take-Home Naloxone Availability Increase Opioid Use?.

Tas, B., Humphreys, K., McDonald, R., and Strang, J. ( 2019) 

Addiction, doi.org/10.1111/add.14637.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14637

USA. FDA approves first generic naloxone nasal spray to treat opioid overdose

Agency is also taking new steps to support development of over-the-counter and additional generics of naloxone to help reduce opioid overdose deaths, increase access to emergency treatment. (FDA – US Fodd and Drug Administration, 19.04.2019)

https://www.fda.gov/news-events/press-announcements/fda-approves-first-generic-naloxone-nasal-spray-treat-opioid-overdose

Evidence-Based Guidelines for EMS Administration of Naloxone.

Williams K, Lang ES, Panchal A, Gasper JJ, Taillac P, Gouda J, Hedges M.

Prehosp Emerg Care. 2019 Mar 29:1-41. doi: 10.1080/10903127.2019.1597955. 

https://www.tandfonline.com/doi/full/10.1080/10903127.2019.1597955

Comparative Human Factors Evaluation of Two Nasal Naloxone Administration Devices: NARCAN® Nasal Spray and Naloxone Prefilled Syringe with Nasal Atomizer.

Tippey KG, Yovanoff M, McGrath LS, Sneeringer P.

Pain Ther. 2019 Mar 15. doi: 10.1007/s40122-019-0118-0. 

https://link.springer.com/article/10.1007%2Fs40122-019-0118-0

Intranasal naloxone rapidly occupies brain mu-opioid receptors in human subjects.

Johansson J, Hirvonen J, Lovró Z, Ekblad L, Kaasinen V, Rajasilta O, Helin S, Tuisku J, Sirén S, Pennanen M, Agrawal A, Crystal R, Vainio PJ, Alho H, Scheinin M.

Neuropsychopharmacology. 2019 Mar 13. doi: 10.1038/s41386-019-0368-x. 

Abstract

https://www.ncbi.nlm.nih.gov/pubmed/30867551

Evaluation and optimization of take-home naloxone in an academic medical center.

Cooler J, Ross CA, Robert S, Linder L, Ruhe AM, Philip A.

Ment Health Clin. 2019 Mar 1;9(2):105-109. doi: 10.9740/mhc.2019.03.105.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398357/

USA. Next-generation single-dose antidotes for opioid overdoses.

American Chemical Society. (ScienceDaily, USA, 31.03.2019)

https://www.sciencedaily.com/releases/2019/03/190331192537.htm